Cold Chain Management
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So, you want to carry blood? There is nothing better than having some O-Low Titer Blood on hand, but do you know how to do it safely and securely? Here’s a quick overview of cold chain management for you.
Whole Blood- Temperature MUST be maintained! For storage, this temp is 1-6degC. For transportation this is 1-10degC. Both ranges are per the FDA for Whole Blood. If CPD is used for anticoagulant storage then the blood will last for 21 days. If CPDA is used for the anticoagulant then the blood is good for 35 days.
Fresh Frozen Plasma (FFP)- typically stored at -30degC. Product must be thawed prior to use (20-30 min in a 30-37degC water bath or in 2-3min by using a designated FFP thawing device). If it isn’t used right away, it can be stored at 1-6degC for up to 12 hours.
Platelets- (more complex based on emerging studies)may be stored at room temp for 5-7 days or cooled for up to 14 days.
Cold Chain Management- If you carry blood on you (passive or active cooling device), you must maintain its temperature in the 1-10degC range. If it goes outside this range, timelines vary based on medical director for how long until you should use it or throw it away. In general, 4-6 hours is a good mark. Ideally you should use an internal temperature gauge where you can read it without opening the container (several Bluetooth options available). These can also help reassure blood bank staff that the blood has been maintained at adequate temp and is acceptable to put back in the inventory.
Administration- Make sure you have a fluid warmer to bring the blood up to 38C/100F (CoTCCC guidelines). Record the DIN (number on the blood bag) along with the casualty info so the record stays with them. For more info on transfusion, check out @nextgenerationcombatmedic for their awesome whole blood toolkit.
